Active NPI
Kristin Leigh Holdom, OTR/L
- Occupational Therapist
- Gardner, MA
National Provider Identifier
1679638233
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10218
- Practice address
- Criterion Child
567 Pearl St.
Gardner, MA 01440 - Phone
- (978) 632-4432
- NPI assigned
- Dec 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | |||
| Occupational Therapist | 225X00000X | 10218 | MA | Primary |
Addresses
Primary practice location
Criterion Child
567 Pearl St.
Gardner, MA 01440
Mailing address
10 Richards Ave
Rutland, MA 01543-1446
Phone (508) 404-7087
Other practice location 1
175 Remsen St
4TH Floor
Brooklyn, NY 11201-4300
Phone (718) 306-1300 ext. 212
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10218 | MA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Healthcare, Inc. | Past | Accepting new patients | |
| Premier Healthcare, Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Developmental Disabilities Clinic/Center
- New York, NY
- NPI 1760436190
-
- Developmental Disabilities Clinic/Center
- New York, NY
- NPI 1831330182
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629417600000",
"number": "1679638233",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 RICHARDS AVE",
"city": "RUTLAND",
"state": "MA",
"postal_code": "015431446",
"telephone_number": "508-404-7087"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "CRITERION CHILD",
"address_2": "567 PEARL ST.",
"city": "GARDNER",
"state": "MA",
"postal_code": "01440",
"telephone_number": "978-632-4432"
}
],
"practiceLocations": [
{
"address_1": "175 Remsen St",
"address_2": "4TH FLOOR",
"address_purpose": "LOCATION",
"city": "Brooklyn",
"state": "NY",
"postal_code": "112014300",
"country_code": "US",
"telephone_number": "718-306-1300 x212",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HOLDOM",
"first_name": "KRISTIN",
"middle_name": "LEIGH",
"name_prefix": "Ms.",
"credential": "OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-26",
"last_updated": "2021-08-20",
"certification_date": "2021-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "MA",
"license": "10218",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gardner, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.